T2 Flashcards
A 54-year-old male who comes to your pharmacy with a prescription for olive oil. You notice that the prescriber has written ‘a.u’ as the direction for use.
Which one of the following is this an abbreviation for?
Apply
As directed
As required
Both ears
Dilute before use
Both ears
You are providing training on side effects of medicines
Which of the following can be a side-effect of desmopressin?
The SmPC is available here: https://www.medicines.org.uk/emc/product/171
Hypocalcaemia
Hypokalaemia
Hypomagnesaemia
Hyponatraemia
Hypophosphataemia
Hyponatraemia
Duration of chloramphenicol OTC treatment maximum
5 days
Mrs T comes into your pharmacy. Her family is going on a cruise in two weeks time and she is concerned in case any of them experiences travel sickness. She has three children aged 4-8 and she wishes to purchase something which will suit the whole family.
Which of the following would be suitable for Mrs T to buy for her children?
Domperidone
Hyoscine butylbromide
Hyoscine hydrobromide
Metoclopramide
Nabilone
Hyoscine hydrrobromide
Which of the following is most likely to interact with grapefruit juice
Bisoprolol
Ciclosporin
Dabigatran
Rosuvastatin
Warfarin
Ciclosporin- Grapefruit juice increases the conc of ciclosporin - manufacterrs advises avoid
You are working in a busy community pharmacy when a mother of a 14-year-old girl asks to speak to the pharmacist. The mother wants to buy some medication OTC for her daughter who is suffering from a headache, raised temperature, a chesty cough and nasal congestion.
Which of the following would NOT be suitable to recommend for this patient?
Aspirin 300 mg tablets
Guaifenesin 100 mg/5 mL & levomenthol 1.1 mg/5 mL oral solution
Ibuprofen 100 mg/5 mL oral suspension
Paracetamol 250 mg/5 mL oral suspension
Xylometazoline 0.1% nasal spray
Aspirin is contraindicated for use in children. Owing to an association with Reye’s syndrome aspirin containing preparations should not be given to children under 16. In this instance; Paracetamol can be used for mild-moderate pain and pyrexia. Ibuprofen can be used for fever with discomfort and pain. Guaifenesin and levomenthol solution can be used as an expectorant. Xylometazoline 0.1% nasal spray can be used as a decongestant.
You receive a emailed digital image of a prescription from a dentist for co-codamol 8/500 mg on a Saturday. When the patient enters the pharmacy to collect the medicine the surgery is closed. The patient tells you it is for dental pain and that he pays for his prescriptions.
What is the most appropriate course of action?
Assess the patient and if appropriate sell OTC co-codamol 8/500 mg
Dispense from the digital image
Make an emergency supply at the request of the patient
Make an emergency supply at the request of the prescriber
Send the patient to a new prescriber for a new prescription
A- Co-codamol 8/500 mg is licensed for dental pain so could be sold following an appropriate assessment. Faxes or digital images are not legal prescriptions, it is difficult to make an emergency supply at the request of the patient because you cannot confirm it has been prescribed before (digital image is not legal), you cannot speak to the prescriber and sending a patient to another prescriber would potentially take up more appointment time.
You are counselling a patient on the use of warfarin.
Which hot drink would you most likely advise her to avoid?
Chamomile tea
Coffee
Earl grey tea
Green tea
Mint tea
The correct answer was Green tea
The effects of coumarins can be reduced or abolished by vitamin K, including that found in health foods, food supplements, enteral feeds, or large amounts of some green vegetables or green tea
Which one of the following is NOT a side-effect from long term topical use of steroid creams?
Adrenal suppression
Alopecia
Skin atrophy
Skin depigmentation
Telangiectasia
Alopecia - More likely to cause hypertrichosis which is the overgrowth of hair
You are the pharmacist on duty in a community pharmacy. A woman visits the pharmacy with her four month old baby, who she is breastfeeding. She complains of a sore throat. She states she has swelling at the back of her mouth and what look like spots. She has no cough but has had a temperature. She asks what she can buy for her symptoms that is suitable while breastfeeding.
What is the most suitable course of action?
Refer her to her dentist
Refer her to her GP for further investigation and/or treatment
Refer her to her GP urgently
Sell her a throat lozenge
Send her to the Accident and Emergency department
The correct answer was Refer her to her GP for further investigation and/or treatment
The patient’s symptoms suggest she may have tonsillitis and she should be referred to the GP for treatment
Which one of the following is most likely to increase the anticoagulant effect of warfarin
Beer
Cranberry Juice
Grapefruit juice
Green Teaa
Spinach, kale, ginger, apple juice
Cranberry
A 30-year-old woman presents in the pharmacy with a productive cough which she has had for a couple of days. She tells you that she has been bringing phlegm up when she coughs and it is yellow-green in colour.
Given this information what condition is most likely?
Acute bacterial infection
Acute viral infection
Chronic bronchitis
Heart failure
Pneumonia
Viral
Sputum colour can be useful in helping to narrow down the differential diagnosis. Viral and bacterial infection can range from sputum with no colour through to yellow, green or brown. Given that viral infection is much more prevalent than bacterial infection then this is the most likely condition in this scenario.
Which one of the following drugs is suitable for use in children aged less than 6 years for the relief of coughs and colds?
Chlorphenamine
Dextromethorphan
Diphenhydramine
Sodium chloride 0.9% nasal drops
Xylometazoline
The correct answer was Sodium chloride 0.9% nasal drops
The MHRA has concluded that some medicines for coughs and colds do not have any evidence which shows that they are effective and in many cases have been linked to undesirable effects including sleep disturbances and hallucinations. Chlorphenamine is licensed for use in children aged 1 year and above but not for use in coughs and colds
When he was cleaning his teeth this morning, he noticed bleeding from his gums. Which of the following is NOT a cause of bleeding gums?
Asthma
Diabetes
Poor oral hygeine
Pregnancy
Smoking
Asthma
Which of the following can cause hyperuricaemia
Allopurinol
Colchicine
Febuxostat
Indapamide
Sulindac
Indapamide like all thiazides can cause hyperuricaemia
You have a patient who may need to stop taking the contraceptive pill.
Which ONE of the following is NOT a reason to STOP the combined oral contraceptive pill?
Hypertension - 135/88 mmHg
Loss of motor or sensory function
New Nipple inversion
Sudden breathlessness
Unexplained swelling of the calf of one leg
Only blood pressure above systolic 160 mmHg or diastolic 100 mmHg is a reason to stop the combined oral contraceptive pill
A person whose spleen was removed following a road traffic accident is seeing their general practitioner.
Which vaccine is indicated for this patient?
Hepatitis A vaccine
Hepatitis B vaccine
Pneumococcal vaccine
Rabies vaccine
Typhoid vaccine
The correct answer was Pneumococcal vaccine
If they have had a splenectomy then they are at an increased risk of pneumococcal infection.
Which of the following beta-blockers is least likely to exacerbate their cold extremities and is therefore the most appropriate for the patient concerned?
A reference is provided here: https://bnf.nice.org.uk/treatment-summary/beta-adrenoceptor-blocking-drugs.html
Atenolol
Carvedilol
Labetalol
Pindolol
Propranolol
The correct answer was Pindolol
ISA and pindolol is the least cardioselective. ISA stands for intrinsic sympathomimetic activity. Intrinsic sympathomimetic activity (ISA, partial agonist activity) represents the capacity of beta blockers to stimulate as well as to block adrenergic receptors. Pindolol has intrinsic sympathomimetic activity; so it tends to cause less bradycardia than the other beta blockers and may also cause less coldness of the extremities.
Miss C is joining your pharmacy team as a work experience student. You receive the morning order of medications and preparations and she is keen to help put them out on the pharmacy shelves.
She asks you which one of the following substances is a prescription only medicine?
Bisacodyl 10 mg suppositories
Dimeticone cutaneous solution
Guaifenesin liquid
Mepyramine maleate 2% cream
Mometasone furoate 0.1% cream
Mometasone furoate 0.1% cream
Which of the following laxative agents is safest for a pregnant woman?
Co-danthramer
Lactulose
Liquid paraffin
Sodium docusate
Sodium picosulphate
BNF monograph for lactulose says not known to be harmful in pregnancy. Other options are not recommended in pregnancy or to be used with caution. Liquid paraffin is not recommended for use as a laxative.
A 29-year-old man comes into your pharmacy to ask for advice. He tells you that he is having difficulty hearing people. He has seen his doctor who told him that he has a build up of wax in his ear canals. He tells you that he is not allergic to any medications but is allergic to almonds. He is otherwise well.
Which one of the following is the suitable treatment option for this man’s complaint?
Cotton buds to be used to remove the wax
Almond oil ear drops
EarCalm® (acetic acid 2%) spray
Gentamicin and hydrocortisone ear drops
Olive oil ear drops
Olive oil
A doctor approaches you on the ward to discuss side effects of antibiotics and in particular antibiotics that may affect the functioning of the liver.
Which of the following antibiotics may cause cholestatic jaundice to occur, up to two months after treatment with this antibiotic has stopped?
Benzylpenicillin sodium
Flucloxacillin
Linezolid
Nalidixic Acid
Phenoxymethylpenicillin
MHRA warning stipulates that flucloxacillin may cause cholestatic jaundice at any time during treatment and up to two months post treatment. Patients should be adequately counselled and report any concerns to a healthcare professional.
Least likely symptom of patient with vaginal thrush
White discharge
Discharge with associated strong odour
Dysuria
Painful sexual intercourse
Vaginal itching and soreness
Discharge with strong odour
You are working in a community pharmacy on a Sunday. A doctor calls and makes an emergency request for a salbutamol inhaler. The request is not part of any NHS service.
When must the doctor present the original prescription to the pharmacy?
Within 24 hours
Within 48 hours
Within 72 hours
Within 84 hours
Within 96 hours
Within 72
